Comparison of Primary Closure, Secondary Closure, and Limberg Flap in the Surgical Treatment of Pilonidal Cysts.

Adult Female Humans Iran Male Middle Aged Pain, Postoperative / etiology Patient Satisfaction Pilonidal Sinus / surgery Surgical Flaps / blood supply Suture Techniques / adverse effects Wound Healing / physiology

Journal

Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses
ISSN: 1550-1841
Titre abrégé: Plast Surg Nurs
Pays: United States
ID NLM: 8403490

Informations de publication

Date de publication:
Historique:
entrez: 28 5 2020
pubmed: 28 5 2020
medline: 22 4 2021
Statut: ppublish

Résumé

There are few studies comparing methods for pilonidal cyst closure. This study was conducted to compare simple surgical closure, secondary healing, and closure using a Limberg flap in the treatment of patients affected with pilonidal cysts. In total, 150 patients with pilonidal cysts were selected and randomized into 3 groups, with 50 participants in each group. Group A underwent primary closure, Group B underwent secondary closure, and Group C underwent closure with a Limberg flap. Operating time, amount of pain after surgery, time to mobilization, time until return to work, time for complete healing, time until being able to sit on the toilet without pain, postoperative complications including infection and recurrence, and seroma and edema after surgery were compared among the 3 groups. Duration of surgery in the Limberg flap group was significantly longer than the duration of surgery in Group A or Group B (p < .001). The time to patient mobilization, the time when the patient returned to work, the time to complete healing, and the time to being able to sit on the toilet without pain were significantly shorter in Group C than in Group A or Group B (p < .001). Although the procedure takes longer when using a Limberg flap, it appears to be a more effective method in the surgical treatment of patients with pilonidal cyst because of the reduced healing time and improved functional status after the procedure.

Identifiants

DOI: 10.1097/PSN.0000000000000297 PMID: 32459755
pubmed: 32459755
doi: 10.1097/PSN.0000000000000297
pii: 00006527-202004000-00006
doi:

Types de publication

Journal Article

Langues

eng

Pagination

81-85

Références

Abdelraheem O., Khalil M. (2017). Comparative study between excision with primary closure versus Limberg flap for treatment of primary sacrococcygeal pilonidal sinus. International Surgery Journal, 4(11), 3581–3585.
Akca T., Colak T., Ustunsoy B., Kanik A., Aydin S. (2005). Randomized clinical trial comparing primary closure with the Limberg flap in the treatment of primary sacrococcygeal pilonidal disease. British Journal of Surgery, 92(9), 1081–1084.
Altintoprak F., Dikicier E., Arslan Y., Ozkececi T., Akbulut G., Dilek O. N. (2010). Comparison of the Limberg flap with V-Y flap technique in the treatment of pilonidal disease. Journal of the Korean Surgical Society, 85(2), 63–67.
Aydede H., Erhan Y., Sakarya A., Kumkumoglu Y. (2001). Comparison of three methods in surgical treatment of pilonidal disease. ANZ Journal of Surgery, 71(6), 362–364.
Brunicardi F. C., Andersen D. K., Dunn D., Hunter J., Pollock R. E. (2010). Schwartz's principles of surgery (8th ed.). New York: McGraw-Hill.
da Silva J. H. (2000). Pilonidal cyst: Cause & treatment. Diseases of the Colon and Rectum, 43(8), 1146–1156.
Ertan T., Koc M., Gocmen E., Aslar A. K., Keskek M., Kilic M. (2005). Does technique alter quality of life after pilonidal sinus surgery? American Journal of Surgery, 190(3), 388–392.
Haji B. B., Ghafuri A. (2010). Surgical management of pilonidal sinus patients by primary and secondary repair methods: A comparative study. Tehran University Medical Journal, 68(9), 553–558.
Hull T. L., Wu J. (2002). Pilonidal disease. Surgical Clinics of North America, 82(6), 1169–1185.
Jabbar M. S., Bhutta M. M., Puri N. (2018). Comparison between primary closure with Limberg flap versus open procedure in treatment of pilonidal sinus, in terms of frequency of post-operative wound infection. Pakistan Journal of Medical Sciences, 34(1), 49–53.
Karaca S. A., Ali R., Çapar M., Karaca S. (2013). Comparison of Limberg flap and excision and primary closure of pilonidal sinus disease, in terms of quality of life and complications. Journal of the Korean Surgical Society, 85(5), 236–239.
Lineaweaver W. C., Brunson M. B., Smith J. F., Franzini D. A., Rumley T. O. (1984). Squamous carcinoma arising in a pilonidal sinus. Journal of Surgical Oncology, 27(4), 239–242.
Maghsudi H., Nazemi N., Ghamari A. A. (2011). Ambulatory treatment of chronic pilonidal sinus with lateral incision and primary suture. Canadian Journal of Surgery, 54(2), 78–82.
Mahdy T. (2008). Surgical treatment of the pilonidal disease: Primary closure or flap reconstruction after excision. Diseases of the Colon and Rectum, 51(12), 1816–1822.
McCallum I., King P. M., Bruce J. (2007). Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database of Systematic Reviews, 4, CD006231.
McCallum I. J., King P. M., Bruce J. (2008). Healing by primary closure versus open healing after surgery for pilonidal sinus: Systematic review and meta-analysis. BMJ, 336(7649), 868–871.
Muzi G. M., Milito G., Cadeddu F., Nigro C., Andreoli F., Amabile D., et al. (2010). Randomized comparison of Limberg flap versus modified primary closure for the treatment of pilonidal disease. The American Journal of Surgery, 200(1), 9–14.
Ommer A., Pitt C., Albrecht K., Marla B., Peitgen K., Walz M. K. (2004). Pilonidal sinus: Primary closure also in case of abscess? Zentralblatt fur Chirurgie, 129(3), 216–219.
Petersen S., Koch R., Stelzner S., Wendlandt T. P., Ludwig K. (2002). Primary closure techniques in chronic pilonidal sinus: A survey of the results of different surgical procedures. Diseases of the Colon and Rectum, 45(11), 1458–1467.
Rao M. M., Zawislak W., Kennedy R., Gilliland R. (2010). A prospective randomised study comparing two treatment modalities for chronic pilonidal sinus with a 5-year follow-up. International Journal of Colorectal Disease, 25(3), 395–400.
Shabbir F., Ayyaz M., Farooka M. W., Toor A. A, Sarwar H., Malik A. A. (2014). Modified Limberg's flap versus primary closure for treatment of pilonidal sinus disease: A comparative study. JPMA: The Journal of the Pakistan Medical Association, 64(11), 1270–1273.
Søndenaa K., Diab R., Gullaksen F. P., Kristiansen R. M., Saebø A., Kømer H. (2002). Influence of failure of primary wound healing on subsequent recurrence of pilonidal sinus. Combined prospective study and randomized controlled trial. European Journal of Surgery, 168(8), 614–618.
Søndenaa K., Andersen E., Nevik I., Søreide J. A. (1995). Patient characteristics and symptoms in chronic pilonidal sinus disease. International Journal of Colorectal Disease, 10(1), 39–42.
Testini M., Piccinni G., Miniello S., Di Venere B., Lissidini G., Nicolardi V., et al. (2001). Treatment of chronic pilonidal sinus with local anaesthesia: A randomized trial of closed compared with open technique. Colorectal Disease, 3(6), 427–430.
Townsend C. M., Beauchamp R. D. (2004). Sabiston textbook of surgery: The biological basis of modern surgical practice (17th ed., p. 1500). Philadelphia, PA: Saunders.
Townsend C. M., Courtney J. R. (2008). Pilonidal disease. In Sabiston textbook of surgery: The biological basis of modern surgical practice (18th ed., p. 1500). Philadelphia, PA: Saunders.
Youssef T., El-Awady S., Farid M. (2015). Tension-free primary closure compared with modified Limberg flap for pilonidal sinus disease: A prospective balanced randomized study. The Egyptian Journal of Surgery, 34(2), 85–89.

Auteurs

Hemmat Maghsudi (H)

Hemmat Maghsudi, MD, was a professor at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojjat Almasi, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Ehsan Mousavai Toomatari, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Masoud Fasihi, MD, is an assistant professor at General Surgery Department, Imam Khomeini Hospital, Faculty of Medicine, Ilam University of Medical Sciences, Tehran, Iran.
Sara Akhavan Salamat, MD, is a resident of anesthesia at Anesthesiology Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Babak Mousavi Toomatari, MD, is an assistant professor at Department of General Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
Mehdi Hemmati, MD, is a resident of internal medicine at Department of Medicine, Medstar Health (Baltimore)/Medstar Georgetown University Hospital, Washington, DC.

Hojjat Almasi (H)

Hemmat Maghsudi, MD, was a professor at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojjat Almasi, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Ehsan Mousavai Toomatari, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Masoud Fasihi, MD, is an assistant professor at General Surgery Department, Imam Khomeini Hospital, Faculty of Medicine, Ilam University of Medical Sciences, Tehran, Iran.
Sara Akhavan Salamat, MD, is a resident of anesthesia at Anesthesiology Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Babak Mousavi Toomatari, MD, is an assistant professor at Department of General Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
Mehdi Hemmati, MD, is a resident of internal medicine at Department of Medicine, Medstar Health (Baltimore)/Medstar Georgetown University Hospital, Washington, DC.

Seyed Ehsan Mousavai Toomatari (SE)

Hemmat Maghsudi, MD, was a professor at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojjat Almasi, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Ehsan Mousavai Toomatari, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Masoud Fasihi, MD, is an assistant professor at General Surgery Department, Imam Khomeini Hospital, Faculty of Medicine, Ilam University of Medical Sciences, Tehran, Iran.
Sara Akhavan Salamat, MD, is a resident of anesthesia at Anesthesiology Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Babak Mousavi Toomatari, MD, is an assistant professor at Department of General Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
Mehdi Hemmati, MD, is a resident of internal medicine at Department of Medicine, Medstar Health (Baltimore)/Medstar Georgetown University Hospital, Washington, DC.

Masoud Fasihi (M)

Hemmat Maghsudi, MD, was a professor at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojjat Almasi, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Ehsan Mousavai Toomatari, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Masoud Fasihi, MD, is an assistant professor at General Surgery Department, Imam Khomeini Hospital, Faculty of Medicine, Ilam University of Medical Sciences, Tehran, Iran.
Sara Akhavan Salamat, MD, is a resident of anesthesia at Anesthesiology Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Babak Mousavi Toomatari, MD, is an assistant professor at Department of General Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
Mehdi Hemmati, MD, is a resident of internal medicine at Department of Medicine, Medstar Health (Baltimore)/Medstar Georgetown University Hospital, Washington, DC.

Sara Akhavan Salamat (S)

Hemmat Maghsudi, MD, was a professor at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojjat Almasi, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Ehsan Mousavai Toomatari, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Masoud Fasihi, MD, is an assistant professor at General Surgery Department, Imam Khomeini Hospital, Faculty of Medicine, Ilam University of Medical Sciences, Tehran, Iran.
Sara Akhavan Salamat, MD, is a resident of anesthesia at Anesthesiology Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Babak Mousavi Toomatari, MD, is an assistant professor at Department of General Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
Mehdi Hemmati, MD, is a resident of internal medicine at Department of Medicine, Medstar Health (Baltimore)/Medstar Georgetown University Hospital, Washington, DC.

Seyed Babak Mousavi Toomatari (SB)

Hemmat Maghsudi, MD, was a professor at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojjat Almasi, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Ehsan Mousavai Toomatari, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Masoud Fasihi, MD, is an assistant professor at General Surgery Department, Imam Khomeini Hospital, Faculty of Medicine, Ilam University of Medical Sciences, Tehran, Iran.
Sara Akhavan Salamat, MD, is a resident of anesthesia at Anesthesiology Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Babak Mousavi Toomatari, MD, is an assistant professor at Department of General Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
Mehdi Hemmati, MD, is a resident of internal medicine at Department of Medicine, Medstar Health (Baltimore)/Medstar Georgetown University Hospital, Washington, DC.

Mehdi Hemmati (M)

Hemmat Maghsudi, MD, was a professor at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojjat Almasi, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Ehsan Mousavai Toomatari, MD, is a surgeon at General Surgery Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Masoud Fasihi, MD, is an assistant professor at General Surgery Department, Imam Khomeini Hospital, Faculty of Medicine, Ilam University of Medical Sciences, Tehran, Iran.
Sara Akhavan Salamat, MD, is a resident of anesthesia at Anesthesiology Department, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Seyed Babak Mousavi Toomatari, MD, is an assistant professor at Department of General Surgery, Zanjan University of Medical Sciences, Zanjan, Iran.
Mehdi Hemmati, MD, is a resident of internal medicine at Department of Medicine, Medstar Health (Baltimore)/Medstar Georgetown University Hospital, Washington, DC.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Régions géographiques › Asie › Asie de l'Ouest › Moyen Orient › Iran › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Douleur postopératoire › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Satisfaction des patients › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Tumeurs › Sinus pilonidal › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Équipement et fournitures › Reconstructions chirurgicales › Lambeaux chirurgicaux › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques de fermeture des plaies › Techniques de suture › Comparison of Primary Closure, Secondary...
questionsmedicales.fr › Phénomènes biologiques › Régénération › Cicatrisation de plaie › Comparison of Primary Closure, Secondary...